Seventy percent of smokers in the U.S. say they want to quit, but studies show that only 2 percent to 3 percent manage to kick the habit each year. Incentives for quitting—avoiding potentially deadly lung cancer and premature wrinkling, saving thousands of dollars annually (in money spent on cigarettes and medical bills stemming from health-related ills), and perhaps even becoming president of the United States—are just not enough, it seems. Could cash succeed where all else failed?
It just might. Researchers report today in the New England Journal of Medicine that smokers were three times more likely to give up cigarettes in return for a few hundred bucks.
"These types of incentives can be very effective in increasing long term [smoking] cessation rates," says lead study author Kevin Volpp, director of the Center for Health Incentives at the University of Pennsylvania School of Medicine and the Wharton School in Philadelphia, noting that employers (not to mention the ailing U.S. healthcare system) could save buckets of dough by offering cigarette-puffing employees cash rewards to quit.
Cigarette smoking is the leading preventable cause of early death in the U.S., claiming some 440,000 lives every year, according to the American Heart Association. The National Cancer Institute (NCI) says that smoking hikes the risk of heart and lung disease, and is responsible for about 30 percent of the 565,650 cancer deaths annually in the U.S. (which includes cancers of the lung, throat, bladder, kidney, pancreas, stomach, and blood).
For their study, Volpp and his colleagues split 878 smokers into two groups: 436 who were offered cash rewards for quitting cigs, and 442 who were offered nothing but a shot at better health. Those in the cash benefit group could earn up to $750: $100 for successfully completing a smoking cessation program, $250 for quitting within the first six months of joining the study, and $400 for keeping clean an additional six months. But lest you think they could just take the money and run-- researchers used urine and saliva tests to confirm their abstinence claims.
Their findings: participants who received monetary rewards were 2.9 times more likely than those sans cash incentives to ditch their smokes for at least six months. When the researchers followed up six months later, they found that the money-makers were still 2.6 times more likely than their empty-handed peers to be smoke-free.
Volpp says the findings could translate into big savings for employers. He notes that studies have shown that it costs companies, on average, about $3,400 per year more to employ and provide health coverage for a smoker than for a non-smoker. Such programs would save smokers money too, as sustaining a pack-a-day smoking habit (the average level of cigarette use among the smokers in the study) costs about $1,400 annually – and more in places like New York City, where the combined City and State cigarette tax is $4.25 per pack (covered by the vendor and the consumer). And then there's the $9.6 billion dollars in lung cancer medical bills racked up annually in the U.S.
Volpp says his team is set to begin a new study on why cash enticements are a big draw for some individuals but not others.